Pediatric Lung MRI: Currently Available and Emerging Techniques

Serai, Suraj D.; Rapp, Jordan B.; States, Lisa J.; Andronikou, Savvas; Ciet, Pierluigi; Lee, Edward Y.

doi:10.2214/ajr.20.23104

Cited by 25 publications

(29 citation statements)

References 47 publications

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“…A secondary objective of the study was to assess the image quality and artifact susceptibility of the sequences in routine clinical use. 5), systemic diseases with potential pulmonary interstitial involvement (4), benign thoracic lesions (4), congenital pulmonary malformations (4), and cystic fibrosis (2). Parental informed consent to participate in the study was obtained before the MRI.…”

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confidence: 99%

Pediatric MR lung imaging with 3D ultrashort‐TE in free breathing: Are we past the conventional T2 sequence?

Gräfe¹,

Anders²,

Prenzel

et al. 2021

Pediatric Pulmonology

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Objectives: Magnetic resonance imaging (MRI) of the lungs is challenging for several reasons, mainly due to the respiratory motion, low proton density, and rapid T2* decay. Recent MR sequences with ultrashort TE (UTE) coupled with respiratory compensation promise to overcome these obstacles. So far, there are very few studies on the relevance of these sequences in children. The aim of the study was to compare the diagnostic value of a respiratory-self-gated three-dimensional UTE sequence versus a conventional respiratory-triggered T2-weighted turbo spin echo (T2-TSE) sequence in a pediatric collective.Study Design: Seventy-one patients between 0 and 18 years of age, who were scheduled for a thoracic MRI based on diverse clinical indications, were examined on a 3T MRI system. The UTE and T2-TSE sequences were evaluated by two readers regarding quality features and visualization of eight common pathology patterns. Results:The image quality of both sequences was equally high, with UTE depicting pleural and central bronchi more clearly. In pathologies, UTE was superior to T2-TSE for so-called "MR-negative pathologies", significant for air trapping, and in tendency for bullae and cysts. In all remaining pathologies, T2-TSE proved to be at least equivalent to UTE.Conclusions: At present, UTE cannot serve as a universal replacement for conventional T2-TSE for all pathologies. It yields, however, a substantial benefit in the context of hyperinflation, emphysema, cysts, or pathologies of the bronchial system.

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confidence: 99%

Pediatric MR lung imaging with 3D ultrashort‐TE in free breathing: Are we past the conventional T2 sequence?

Gräfe¹,

Anders²,

Prenzel

et al. 2021

Pediatric Pulmonology

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“…With their exceptional capability in imaging ultrashort T2* structures, ultrashort TE sequences including ZTE and UTE showed excellent performances in detecting pulmonary nodules [ 21 , 22 , 23 , 24 ]. In the present study, subjective image qualities regarding visualization of intrapulmonary structures such as pulmonary vessels, bronchi, and fissures; degree of image noise/artifacts; and overall acceptability were all superior in ZTE- AIR.…”

Section: Discussionmentioning

confidence: 99%

Application of Highly Flexible Adaptive Image Receive Coil for Lung MR Imaging Using Zero TE Sequence: Comparison with Conventional Anterior Array Coil

Bae

Jeon

Hwang³

et al. 2022

Diagnostics

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(1) Background: Highly flexible adaptive image receive (AIR) coil has become available for clinical use. The present study aimed to evaluate the performance of AIR anterior array coil in lung MR imaging using a zero echo time (ZTE) sequence compared with conventional anterior array (CAA) coil. (2) Methods: Sixty-six patients who underwent lung MR imaging using both AIR coil (ZTE-AIR) and CAA coil (ZTE-CAA) were enrolled. Image quality of ZTE-AIR and ZTE-CAA was quantified by calculating blur metric value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of lung parenchyma. Image quality was qualitatively assessed by two independent radiologists. Lesion detection capabilities for lung nodules and emphysema and/or lung cysts were evaluated. Patients’ comfort levels during examinations were assessed. (3) Results: SNR and CNR of lung parenchyma were higher (both p < 0.001) in ZTE-AIR than in ZTE-CAA. Image sharpness was superior in ZTE-AIR (p < 0.001). Subjective image quality assessed by two independent readers was superior (all p < 0.05) in ZTE-AIR. AIR coil was preferred by 64 of 66 patients. ZTE-AIR showed higher (all p < 0.05) sensitivity for sub-centimeter nodules than ZTE-CAA by both readers. ZTE-AIR showed higher (all p < 0.05) sensitivity and accuracy for detecting emphysema and/or cysts than ZTE-CAA by both readers. (4) Conclusions: The use of highly flexible AIR coil in ZTE lung MR imaging can improve image quality and patient comfort. Application of AIR coil in parenchymal imaging has potential for improving delineation of low-density parenchymal lesions and tiny nodules.

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“…The lack of radiation makes pulmonary MRI an ideal modality for pediatric examinations, pregnant women, and patients requiring serial and longitudinal follow-up. In pediatric patients, the clinical indications involve the evaluation of lung air perfusion patterns in pulmonary hypertension, early detection and follow-up for asthma, cystic fibrosis, pulmonary embolism, and bronchiolitis obliterans [ 31 ]. In addition, pulmonary MRI sequences could be included in the body MRI sequence for patients who need thorough evaluation of both the lungs and body organs in a single imaging session.…”

Section: Discussionmentioning

confidence: 99%

Applying Compressed Sensing Volumetric Interpolated Breath-Hold Examination and Spiral Ultrashort Echo Time Sequences for Lung Nodule Detection in MRI

Huang

Niisato²,

et al. 2021

Diagnostics

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This prospective study aimed to investigate the ability of spiral ultrashort echo time (UTE) and compressed sensing volumetric interpolated breath-hold examination (CS-VIBE) sequences in magnetic resonance imaging (MRI) compared to conventional VIBE and chest computed tomography (CT) in terms of image quality and small nodule detection. Patients with small lung nodules scheduled for video-assisted thoracoscopic surgery (VATS) for lung wedge resection were prospectively enrolled. Each patient underwent non-contrast chest CT and non-contrast MRI on the same day prior to thoracic surgery. The chest CT was performed to obtain a standard reference for nodule size, location, and morphology. The chest MRI included breath-hold conventional VIBE and CS-VIBE with scanning durations of 11 and 13 s, respectively, and free-breathing spiral UTE for 3.5–5 min. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and normal structure visualizations were measured to evaluate MRI quality. Nodule detection sensitivity was evaluated on a lobe-by-lobe basis. Inter-reader and inter-modality reliability analyses were performed using the Cohen κ statistic and the nodule size comparison was performed using Bland–Altman plots. Among 96 pulmonary nodules requiring surgery, the average nodule diameter was 7.7 ± 3.9 mm (range: 4–20 mm); of the 73 resected nodules, most were invasive cancer (74%) or pre-invasive carcinoma in situ (15%). Both spiral UTE and CS-VIBE images achieved significantly higher overall image quality scores, SNRs, and CNRs than conventional VIBE. Spiral UTE (81%) and CS-VIBE (83%) achieved a higher lung nodule detection rate than conventional VIBE (53%). Specifically, the nodule detection rate for spiral UTE and CS-VIBE reached 95% and 100% for nodules >8 and >10 mm, respectively. A 90% detection rate was achieved for nodules of all sizes with a part-solid or solid morphology. Spiral UTE and CS-VIBE under-estimated the nodule size by 0.2 ± 1.4 mm with 95% limits of agreement from −2.6 to 2.9 mm and by 0.2 ± 1.7 mm with 95% limits of agreement from −3.3 to 3.5 mm, respectively, compared to the reference CT. In conclusion, chest CT remains the gold standard for lung nodule detection due to its high image resolutions. Both spiral UTE and CS-VIBE MRI could detect small lung nodules requiring surgery and could be considered a potential alternative to chest CT; however, their clinical application requires further investigation.

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Pediatric Lung MRI: Currently Available and Emerging Techniques

Cited by 25 publications

References 47 publications

Pediatric MR lung imaging with 3D ultrashort‐TE in free breathing: Are we past the conventional T2 sequence?

Pediatric MR lung imaging with 3D ultrashort‐TE in free breathing: Are we past the conventional T2 sequence?

Application of Highly Flexible Adaptive Image Receive Coil for Lung MR Imaging Using Zero TE Sequence: Comparison with Conventional Anterior Array Coil

Applying Compressed Sensing Volumetric Interpolated Breath-Hold Examination and Spiral Ultrashort Echo Time Sequences for Lung Nodule Detection in MRI

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